NPI | 1205398591 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810008460) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-04-04 |
Last Update Date | 2024-08-14 |